Rectovestibular fistula with normal anus: a treatment alternative.

Congenital rectovestibular fistulas with normal anus are a rare form of anorectal malformations, especially in the Western hemisphere. Due to its rarity, consensus on preoperative management, surgical technique and postoperative care is still in debate. We describe a specific case with its management plan and outcomes while providing an up to date literature review on current management trends.

Breast asymmetry pattern in women with idiopathic scoliosis.

Breast asymmetry is frequent in women with idiopathic scoliosis. To understand the pattern of breast asymmetry in these women a clinical study was performed in which 54 female patients with idiopathic scoliosis were evaluated. The information recorded for each patient included: age, weight, height, scoliosis type, Cobb angle, breast measurements, and presence of rib cage asymmetry.

Pulmonary metastasectomy for children with malignant tumors.

In children with primary solid malignant tumors the most frequent site of metastasis is usally the lung. Pulmonary metastasectomy is part of the standard of care in adult malignancies but its role in pediatric patients has been poor characterized. This review article discusses the benefits, outcomes according tumor histology, selection criteria, adjuvant therapies and surgical techniques employed in the resection of pulmonary metastases in children with malignant tumors.

Fistula-in-ano in children: a case series.

Background: Fistula-in-ano is an abnormal connection between the inner surface of the anal canal and the perineal skin.

Methods: Between 2001 and 2010, seventeen patients with fistula-in-ano were surgically managed by a single surgeon within the University Pediatric Hospital and HIMA-San Pablo Hospital.

Results: There were 16 males and 1 female.

Laparoscopic splenectomy for infarcted splenoptosis in a child: a case report.

Wandering spleen is a rare birth defect characterized by absence or weakness of one or more of the ligaments that hold the spleen in its normal position. In this report we present the case of a 6-year-old girl admitted with diffuse abdominal pain, fever and emesis. Ultrasound and CT scan revealed the spleen was not found in its normal anatomical position.

Anesthetic management of a patient undergoing surgery for bilateral pheochromocytoma: a case report.

Pheochromocytomas are rare neuroendocrine tumors. Patients with pheochromocytoma may develop potentially lethal cardiovascular and other complications, especially in the setting of diagnostic or interventional procedures (e.g.

Arbona system reengineered in the Garcia-Ariz Model: a national health reform plan from an orthopedics program perspective.

During the 1950's the healthcare system of Puerto Rico was maintained exclusively by the local government. The Arbona system, as it came to be known, although it provided health care professionals on the island with multiple educational experiences, presented substantial costs for the government. In the early 1990's a program of privatization known as "La Reforma" was implemented with the ultimate goal of providing a universal coverage system for the poor and the needy.

Esophageal atresia: new guidelines in management.

Esophageal atresia is the most common congenital anomaly of the esophagus in newborns. This review article discusses the incidence, embryological classification, diagnosis and associated anomalies of esophageal atresia. Emphasis is placed in the current guidelines of standard surgical management of this congenital condition.

Challenging educational electrocardiography cases.

Three challenging educational electrocardiography cases are presented and the electrocardiographic findings discussed.

Cardiovascular services and human resources in Puerto Rico - 2008.

Available information (2004-2008) concerning population statistics, the occurrence of cardiovascular disease, cardiovascular services and human resources in Puerto Rico is presented. Relevant information concerning life expectancy at birth, death by specific causes in a recent four years period, the commonest causes of death, and the related cardiovascular risk factors prevalence data available is included. The surgical and medical interventional services rendered to cardiovascular patients in different institutions and their locations in Puerto Rico in the year 2008 is presented.

Delayed thrombolysis in a patient presenting after 12 hours of chest pain, cardiogenic shock and life-threatening arrhythmias.

This 63 years old man presented to the emergency room with chest pain of more than 12 hours duration. The initial electrocardiogram showed as ST segment elevation inferior and right ventricular infarction. He developed signs and symptoms consistent with cardiogenic shock, followed by life threatening ventricular fibrillation and cardiac arrest.

Complicated bronchiolitis: another use for your bedside ultrasound in the emergency department.

Diaphragmatic eventration or diaphragmatic herniations are congenital defect that involve abnormal development of the diaphragm and stretching of the muscular fibers leading to protrusion of abdominal organs into the thoracic cavity. Left sided defects will lead to stomach contents into the chest cavity while, right sided defects will have bowel or liver in the thoracic cavity. Infants with Congenital diaphragmatic hernia often present with respiratory distress that can be life-threatening unless treated appropriately.

Coagulopathy induced by saw palmetto: a case report.

Saw palmetto is the most popular herbal supplement used to treat symptoms of benign prostatic hyperplasia (BPH). The safety and efficacy of saw palmetto has been established in the literature. While the majority of studies document the efficacy and safety of saw palmetto, some studies document the adverse side effects, including increased risk of bleeding.

Successful conservative management of Ludwig's angina in advanced pregnancy.

A 20 year-old female in her 32nd week of gestation presented to the Emergency Department with dysphonia and dysphagia associated to a recent recurrence of a periapical abscess. Her oral examination showed trismus, elevated tongue and neck swelling. A clinical diagnosis of Ludwig's angina was reached, and empirical antibiotic coverage was started.

Marital and job satisfaction among non-resident physicians at a Hispanic academic medical center, 2006-2007.

Marital satisfaction has been previously associated with job satisfaction although few studies have addressed this issue among Hispanic physicians. Marital and job satisfaction were assessed in a sample of 92 legally married non-residents physicians working at a Hispanic Academic Medical Center during the 2006-2007 academic year. Marital satisfaction was assessed using the Dyadic Adjustment Scale (DAS) and job satisfaction was measured using a 18-item scale.